How does mouthwash affect your oral microbiome. Can certain ingredients in mouthwash cause more harm than good. What are the potential benefits and drawbacks of using mouthwash regularly. Is mouthwash necessary for maintaining optimal oral health.

The Composition of Mouthwash: Understanding What You’re Swishing

Mouthwash is a common oral hygiene product found in many households. But have you ever wondered what exactly is in that bottle of minty freshness? Let’s dive into the typical ingredients found in over-the-counter mouthwashes:

• Alcohol
• Fluoride
• Peroxide
• Essential oils
• Flavorings and dyes

Each of these ingredients serves a specific purpose, from killing bacteria to freshening breath. Prescription mouthwashes, on the other hand, may contain stronger ingredients like chlorhexidine, which are designed to target specific oral health issues such as gingivitis, dry mouth, or mouth sores resulting from medical treatments.

The Potential Benefits of Incorporating Mouthwash into Your Oral Care Routine

While mouthwash should never replace brushing and flossing, it can offer several benefits when used as part of a comprehensive oral hygiene regimen. Here are some potential advantages:

Strengthening Tooth Enamel

Can mouthwash really help protect your teeth? Fluoride-containing mouthwashes can indeed strengthen your enamel and provide an additional layer of defense against tooth decay. However, it’s important to note that the fluoride concentration in over-the-counter mouthwashes is typically lower than that found in toothpaste. For this reason, dental professionals often recommend using mouthwash before brushing to maximize the benefits of your fluoride toothpaste.

Reaching Hard-to-Clean Areas

How effective is mouthwash at cleaning your entire mouth? While it shouldn’t be considered a substitute for brushing and flossing, mouthwash can reach areas that might be challenging to clean with traditional oral care tools. The swishing action helps to dislodge food particles and kill bacteria in hard-to-reach spots, complementing your regular brushing and flossing routine.

Combating Bad Breath

Is mouthwash a reliable solution for halitosis? If your bad breath is caused by bacteria, an antibacterial mouthwash could indeed help freshen your breath. However, it’s crucial to choose a mouthwash that targets the underlying cause of halitosis rather than one that simply masks odors with temporary flavorings. When selecting a mouthwash for bad breath, look for ingredients that specifically combat odor-causing bacteria.

Potential Drawbacks: When Mouthwash Might Do More Harm Than Good

While mouthwash can offer benefits, it’s essential to be aware of potential drawbacks. Here are some concerns to consider:

Disrupting the Oral Microbiome

Is it possible for mouthwash to be too effective at killing bacteria? Surprisingly, yes. Your mouth is home to a diverse community of microorganisms known as the oral microbiome. These bacteria play crucial roles in maintaining oral and overall health, from breaking down nutrients to regulating blood pressure and protecting against inflammation. The indiscriminate antibacterial action of some mouthwashes may disrupt this delicate balance, potentially leading to unintended consequences for your oral health.

Oral Irritation and Dryness

Why do some people experience a burning sensation when using mouthwash? Alcohol-based mouthwashes are often the culprit behind that intense tingling feeling. While some users enjoy this sensation, it can be problematic for others, particularly those with sensitive teeth and gums or existing mouth sores. Moreover, alcohol-based rinses may contribute to dry mouth, which can exacerbate oral health issues. If you find alcohol-based mouthwashes too harsh, consider switching to an alcohol-free alternative.

The Alcohol Controversy: Weighing the Risks and Benefits

The use of alcohol in mouthwash has been a topic of debate in the dental community. While alcohol is effective at killing bacteria, its presence in oral rinses has raised some concerns:

Potential Link to Oral Cancer

Does using alcohol-based mouthwash increase your risk of oral cancer? Some studies have suggested a possible connection between long-term exposure to alcohol-containing mouthwashes and an elevated risk of oral cancer. While more research is needed to establish a definitive causal relationship, many dental professionals recommend opting for alcohol-free formulas, especially for frequent mouthwash users.

Alternatives to Alcohol-Based Mouthwashes

What options are available for those seeking alcohol-free mouthwashes? Fortunately, the market now offers a wide range of alcohol-free mouthwashes that can provide similar benefits without the potential risks associated with alcohol. These alternatives often use other antibacterial agents, such as cetylpyridinium chloride or essential oils, to combat oral bacteria and freshen breath.

Unexpected Side Effects: When Mouthwash Causes Staining

Can mouthwash actually stain your teeth? It may sound counterintuitive, but certain mouthwash ingredients have been associated with tooth discoloration. Specifically, rinses containing cetylpyridinium chloride or chlorhexidine—often prescribed for treating bad breath or gingivitis—may cause brown staining on teeth with prolonged use.

If you’ve been prescribed a mouthwash containing these ingredients and are concerned about potential staining, it’s important to discuss this with your dentist or pharmacist. They may be able to recommend strategies to minimize staining or suggest alternative products that can address your oral health needs without this side effect.

Personalizing Your Oral Care: Is Mouthwash Right for You?

Given the potential benefits and drawbacks of mouthwash, you might be wondering whether it’s a necessary addition to your oral care routine. The truth is, there’s no one-size-fits-all answer. The decision to use mouthwash should be based on your individual oral health needs and preferences.

Consulting with Dental Professionals

How can you determine if mouthwash is right for your oral care routine? The best approach is to consult with your dentist or dental hygienist. These professionals can assess your oral health, consider any specific concerns or conditions you may have, and provide personalized recommendations. They can help you weigh the pros and cons of different mouthwash formulations and determine whether incorporating a rinse into your routine would be beneficial.

Choosing the Right Mouthwash

If you and your dental professional decide that mouthwash could be a valuable addition to your oral care regimen, the next step is selecting the right product. Consider the following factors when choosing a mouthwash:

• Your specific oral health needs (e.g., cavity prevention, gum health, breath freshening)
• Presence or absence of alcohol
• Fluoride content
• Additional active ingredients
• Potential for staining
• Personal taste preferences

Remember that different mouthwashes are formulated to address specific oral health concerns. A fluoride rinse might be ideal for someone prone to cavities, while an antibacterial formula could be more suitable for someone struggling with gum disease or persistent bad breath.

Integrating Mouthwash into Your Oral Hygiene Routine

If you’ve decided to incorporate mouthwash into your oral care regimen, it’s important to use it correctly to maximize its benefits and minimize potential drawbacks. Here are some tips for effective mouthwash use:

Timing Matters

When is the best time to use mouthwash in relation to brushing and flossing? If you’re using a fluoride mouthwash, it’s generally recommended to use it before brushing. This allows the fluoride in your toothpaste to have maximum contact with your teeth. For other types of mouthwash, using it after brushing and flossing can help rinse away any loosened debris and provide a final antibacterial sweep of your mouth.

Proper Technique

How should you use mouthwash for optimal results? Follow these steps for effective mouthwash use:

1. Measure the recommended amount of mouthwash as indicated on the product label.
2. Swish the mouthwash vigorously around your mouth for the recommended duration (typically 30 seconds to 1 minute).
3. Gargle gently to reach the back of your throat and tongue.
4. Spit out the mouthwash completely. Do not swallow.
5. Avoid eating or drinking for at least 30 minutes after using mouthwash to allow any active ingredients to continue working.

Frequency of Use

How often should you use mouthwash? The ideal frequency of mouthwash use can vary depending on the type of mouthwash and your individual oral health needs. Some mouthwashes are designed for daily use, while others may be recommended for use only a few times per week. Always follow the instructions on the product label or the recommendations of your dental professional.

Beyond Mouthwash: Holistic Approaches to Oral Health

While mouthwash can be a useful tool in maintaining oral health, it’s important to remember that it’s just one part of a comprehensive oral care routine. To truly optimize your oral health, consider these additional strategies:

Dietary Considerations

How does your diet impact your oral health? The foods and beverages you consume can have a significant effect on your teeth and gums. A diet rich in sugary and acidic foods can increase your risk of tooth decay and enamel erosion. On the other hand, consuming foods high in calcium and vitamin D can help strengthen your teeth. Additionally, crunchy fruits and vegetables can help naturally clean your teeth and stimulate saliva production, which aids in neutralizing harmful acids in your mouth.

Hydration and Oral Health

Can drinking water improve your oral health? Absolutely. Staying well-hydrated is crucial for maintaining a healthy mouth. Water helps rinse away food particles and bacteria, neutralize acids, and promote saliva production. Saliva is your body’s natural defense against tooth decay, helping to remineralize your teeth and wash away harmful bacteria.

The Role of Probiotics

Can probiotics benefit your oral health? Emerging research suggests that probiotics may play a role in promoting oral health by helping to maintain a balanced oral microbiome. While more studies are needed to fully understand their effects, incorporating probiotic-rich foods or supplements into your diet might contribute to a healthier mouth.

Regular Dental Check-ups

How often should you visit your dentist? Regular dental check-ups and professional cleanings are essential for maintaining optimal oral health. Most dental professionals recommend visiting the dentist every six months for routine examinations and cleanings. These visits allow your dentist to detect and address any potential issues early on, preventing more serious problems from developing.

In conclusion, while mouthwash can be a valuable addition to your oral care routine, it’s important to approach its use thoughtfully. By understanding the potential benefits and drawbacks, consulting with dental professionals, and choosing the right product for your needs, you can make informed decisions about incorporating mouthwash into your oral hygiene regimen. Remember that mouthwash is just one tool in the broader context of oral health care, and a holistic approach that includes proper brushing, flossing, a healthy diet, and regular dental check-ups is key to maintaining a healthy, beautiful smile.

Is Mouthwash Bad for You?

You just woke up from a long night’s sleep. Or ate a meal chock full of garlic. There’s nothing like that fresh feeling after swishing some mouthwash, right? But does “fresh” mean “healthy”?

“The concept behind most popular mouthwashes is to kill bacteria in your mouth,” says Natalie Stinton, DMD, a pediatric dentist at Geisinger. “These bacteria can lead to tooth decay, gum disease and halitosis, more commonly known as bad breath.”

But if it works a little too well at killing off bacteria, could mouthwash actually be bad for you? Before you swish and spit, consider these facts.

What’s in your mouthwash?

Your pharmacy’s shelves are probably stocked with rinses targeting all kinds of dental concerns, from breath freshening to teeth whitening. The ingredients of each can vary depending on its intended use.

Some common over-the-counter mouthwash ingredients are:

• Alcohol
• Fluoride
• Peroxide
• Essential oils
• Flavoring and dyes

Prescription mouthwashes contain stronger ingredients (like chlorhexidine) and may be used to target specific conditions like:

• Gingivitis
• Dry mouth
• Dry socket after having a tooth pulled
• Mouth sores from chemotherapy or radiation

Benefits of mouthwash

Depending on the ingredients and your goals, mouthwash can be part of a good oral hygiene routine. Some potential benefits include:

Strengthening enamel

“Mouthwashes containing fluoride can help strengthen your enamel and protect against tooth decay,” says Dr. Stinton.

But if you’re using both a fluoride toothpaste and mouthwash, it’s best to rinse first then brush.

“Over-the-counter mouthwashes have less fluoride than toothpaste, so rinsing after brushing could wash away the stronger cavity protection benefits,” says Dr. Stinton.

Reaching all corners of your mouth

Mouthwash can reach areas that might be hard to get with your toothbrush or floss alone.

“Rinses should never replace brushing and flossing,” says Dr. Stinton. “But they can help kill harmful bacteria you might have missed.”

Eliminating bad breath

If your bad breath is caused by bacteria, antibacterial mouthwash could help freshen things up. But pay attention to the ingredients to make sure you’re addressing the underlying problem.

“Some over-the-counter mouthwashes rely on flavorings to temporarily mask bad breath. To treat halitosis, you need a rinse that targets the bacteria causing it,” explains Dr. Stinton.

Drawbacks of mouthwash

Still, there are some factors to consider before adding a rinse to your routine:

Killing bacteria a little too well

You might’ve heard about the “good” bacteria in your gut, but your mouth is also home to a thriving community of microorganisms.

Known collectively as your “oral microbiome,” the bacteria in your mouth play an important role in keeping you healthy. Some help break down nutrients and regulate blood pressure while others protect against inflammation.

“The problem is that while there are bad and smelly bacteria we want to get rid of, there are also good bacteria that we need, and antibacterial mouthwash doesn’t differentiate,” says Dr. Stinton. “More research is needed, but overusing mouthwash could throw off your mouth’s microbiome.”

Irritation, burning and dryness

While some people enjoy feeling the burn after swigging mouthwash, it’s not always a good thing.

“Alcohol-based mouthwashes tend to cause a burning or tingling sensation that can be too intense for some people,” says Dr. Stinton. “This can irritate mouth sores, make tooth and gum sensitivity worse or lead to dryness.”

If you’re not a fan of this burning feeling, reach for an alcohol-free formula.

May increase risk of oral cancer

Irritation isn’t the only reason you may want to switch to alcohol-free mouthwash.

“Some studies suggest that long-term alcohol exposure can increase your risk of oral cancer,” says Dr. Stinton. “More research is needed to determine if there’s a true cause and effect, but it’s worth sticking with an alcohol-free formula if you’re a frequent mouthwash user.”

Staining teeth

It sounds counterintuitive, but some mouthwashes can cause tooth stains rather than prevent them.

“Studies have shown that rinses with the ingredients cetylpyridinium chloride or chlorhexidine, commonly prescribed to treat bad breath or gingivitis, could cause brown staining on teeth,” says Dr. Stinton.

If you’ve been prescribed one of these mouthwashes and are concerned about stains, talk with your dentist or pharmacist about ways to reduce this side effect.

So, is mouthwash necessary?

“There’s no hard evidence to say whether or not mouthwash is bad for you,” says Dr. Stinton. “Your dentist can help you weigh the pros and cons and determine if it’s right for you.”

Ultimately, deciding whether or not to use mouthwash mostly comes down to personal preference. Your dentist or primary care provider can help evaluate your needs and recommend the right product for you.

Ready to rinse? Here’s how to use mouthwash:

1. Use your mouthwash before brushing to avoid washing away your toothpaste’s fluoride benefits.
2. Pour the recommended amount into a cup.
3. Swish and gargle for around 30 seconds, being careful not to swallow any. Note: Unless directed by your dentist or pediatrician, children under 6 should not use mouthwash due to the risk of swallowing it.
4. Spit the mouthwash out.
5. Follow your rinse by brushing for at least two minutes with fluoride toothpaste. Wait at least 30 minutes before eating, drinking or rinsing.

All that’s left to do is smile and enjoy that fresh feeling.

Next steps:

Learn more about dental care at Geisinger
What’s behind your bad breath?
Could not brushing your teeth make you sick?

Is Mouthwash Bad for You? Effects, Risks, Who Should’t Use It

Mouthwash, also called “oral rinse” or “mouth rinse,” typically contains antibacterial ingredients to clean between your teeth, as well as other ingredients that give it a flavor. Some types of mouthwash contain alcohol as an inactive ingredient, while others are alcohol-free.

For some people, mouthwash can have some unpleasant side effects. These side effects may outweigh the benefits of using an over-the-counter oral rinse as part of your everyday routine. Other people have expressed concerns over some of the chemical dyes and flavors in certain brands of mouthwash.

That being said, mouthwash isn’t bad for you, per se. Let’s take a look at the side effects of mouthwash and what you should know about using it safely.

Alcohol is used as a preservative ingredient and as a carrier for the other active ingredients in mouthwash, not as an antiseptic ingredient.

Not every person will experience all of the following side effects of mouthwash, and certain formulas are more likely to cause more or fewer side effects.

May cause or irritate canker sores

An ingredient called sodium lauryl sulfate (SLS) is used in some toothpaste and oral rinses to create a “foaming” action in your mouth.

If you’re prone to developing canker sores, using a mouth rinse (or any oral product) that contains SLS might cause an outbreak of sores or make them worse. People who are currently undergoing chemotherapy treatment may also find that to be the case.

If you don’t have these sensitivities or concerns, it’s likely that you won’t experience this side effect.

May cause dry mouth

Xerostomia, also known as dry mouth, refers to a condition where your salivary glands don’t produce enough saliva to keep your tongue lubricated and to help prevent cavities.

An oral rinse that contains fluoride may actually be recommended if you have dry mouth, according to the American Dental Association. However, a mouthwash that contains alcohol may actually make symptoms of dry mouth worse.

May cause burning or pain when you use it

Some people enjoy the feeling of a tingling sensation when they use mouthwash that contains alcohol. But for others, the feeling can be more like a burning pain.

Some mouthwashes contain up to 25 percent alcohol, which makes this sensation more powerful.

Some side effects of mouthwash aren’t related to whether there is alcohol in the formula.

May remove your healthy oral microbiome

Any type of mouthwash, whether alcohol-free or containing alcohol, may kill off a high number of bacteria in your mouth.

Some bacteria in your mouth can lead to cavities and bad breath, but other bacteria are actually part of what’s called your oral microbiome, which helps break down your food and maintains healthy teeth and gums.

Killing off all of the bacteria in your mouth on a regular basis isn’t recommended, so gentler antiseptic formulas can be a healthier choice.

May cause teeth staining

The most common side effect of using mouthwash, according to a review published in 2019, was teeth staining.

Mouthwash that contains an ingredient called chlorhexidine (CHX), which is only is available by prescription, is more likely to cause temporary teeth staining after use.

Mouthwashes that contain bright dyes are more likely to cause staining than dye-free mouthwash.

May be linked with increased cancer risk

Mouthwash may also contain synthetic ingredients that have been linked to an increased risk of certain cancers.

A 2016 study concluded that people who regularly use mouthwash may have a slightly elevated risk of head and neck cancers than people who never used mouthwash.

A lot more research is needed to understand whether this link is real and, if so, which ingredients cause the risk to increase.

There’s such a thing as using mouthwash too often.

Most nonprescription mouthwashes advise you to use the product twice per day, along with brushing and flossing. Some people like to use mouthwash more than that, using it to freshen breath or get that “clean mouth” feeling in between meals.

You should cut back or discontinue mouthwash use if you experience any of the following symptoms:

• persistent or inflamed canker sores
• bleeding gums when you use your mouthwash
• symptoms of dry mouth
• pain or sensitivity when you brush your teeth after using mouthwash
• teeth staining

Children under the age of 6 shouldn’t use mouthwash, and kids over 6 should be supervised whenever they use mouthwash, according to the American Dental Association.

If you have sores in your mouth, have a compromised immune system, or you’re currently undergoing chemotherapy, you might want to avoid using mouthwash.

If you have had an allergic reaction to any type of mouthwash ingredient (such as with flomenthol, xylitol, or SLS), check labels carefully to make sure that you’re not using a product that may cause irritation.

Mouthwash does have some health benefits. However, according to the American Dental Association, you should look for vetted formulas that have the organization’s seal of approval.

Over-the-counter mouthwash can:

• freshen breath and treat halitosis
• reduce your risk of gingivitis (gum disease)
• reduce plaque buildup to help prevent cavities
• make teeth look visibly whiter

That said, no mouthwash formula is a substitute for regular brushing and flossing twice per day, which is the foundation of good dental hygiene.

There are alternatives to using mouthwash. Flossing and brushing twice per day have more proven benefits and fewer possible side effects.

Additionally, you may want to ask a dentist about prescription oral rinses. These rinses have higher levels of certain active ingredients, making them effective for temporary use for the treatment of certain oral conditions. You can use prescription oral rinses for:

• symptoms of dry mouth
• gum disease prevention
• pain relief for mouth ulcers/canker sores
• preventing infection and dry socket following a dental extraction or other oral surgery

Mouthwash can have some unpleasant side effects. Some of these side effects are only caused by mouthwash formulas that contain alcohol or certain other ingredients.

But on the whole, mouthwash isn’t bad for your health or harmful for you to use. You can use mouthwash as a part of a healthy oral hygiene routine, or you can opt out of using it. It’s really just a matter of personal preference.

If you have chronic bad breath, are concerned about plaque buildup and gum disease, or are generally curious about improving your dental health, you should speak with your dentist.

A Good and Necessary Habit – Using Mouthwash

We most often think about whether we need a mouthwash only when we notice the appearance of visible gum problems, such as soreness, bleeding and swelling. In other cases, we neglect this oral hygiene product, but this is in vain. Rinses help to solve a whole range of problems with teeth and gums, and most importantly, they are an effective and very simple way to prevent tooth decay, bad breath or gum disease.

The main benefit of regular use of mouth rinses is a significant improvement in the hygiene of the teeth and gums, namely a significant reduction in the rate of plaque formation in the oral cavity. Rinses are easy to use and, thanks to their liquid consistency, are able to clean not only the surface of the teeth, but also the interdental spaces, the area of ​​​​the palate, cheeks and tongue.

In the presence of periodontal pockets, orthodontic constructions in the oral cavity, in which food debris can accumulate, rinses are simply irreplaceable. They not only improve the quality of cleansing after meals, but also protect the surface of the teeth and gums from the “sticking” of bacteria and the formation of dense plaque during the day.

There is another side to the rinse aid issue. Is mouthwash useful when there are no specific indications for its use?

It is worth mentioning right away that there is no real need for the use of medicated rinses (drugs) unless there is any specific oral problem. In such a situation, only a dentist can prescribe a specialized type of mouthwash.

As far as hygienic rinses are concerned, like toothpastes, they are suitable for daily use. They represent a different form of application and help to achieve a better cleaning of the oral cavity. Therefore, dentists recommend using mouthwash after every brushing.

When choosing a prophylactic or hygienic rinse, you should pay attention to two points: the presence of strong antibacterial components (alcohol, chlorhexidine, triclosan) in the composition and the presence of active substances in the composition to which you have an allergic reaction. Rinses containing chlorhexidine have limitations on the duration of use. Chlorhexidine kills not only harmful microorganisms, but also the beneficial microflora of the oral cavity.

If you’re wondering if even natural-based mouthwashes are harmful, look at the manufacturer’s additional quality guarantees. Very often, manufacturers conduct clinical trials of their products and receive recommendations from the dental community to ensure that their products are safe for regular use.

“Forest Balsam” conditioners are developed on the basis of a decoction of herbs, their action is due to a high concentration of active plant components (such as aloe juice, fir extract, tea tree oil, etc.). All Forest Balsam rinses undergo clinical and microbiological testing, which confirms that these rinses are safe for the oral microflora and do not disturb the natural biocenosis of the oral cavity.

Moreover, “Forest Balsam” rinses (for example, “For inflammation of the gums” and “For bleeding gums”) are approved by the Dental Association of Russia and are recommended for use by women during pregnancy.

“Forest Balsam” rinses maintain the balance of the natural microflora of the oral cavity during long-term use, according to clinical and microbiological tests, RF 2014-2016. Before use, consultation with a specialist is recommended due to the possible individual reaction to the components of the composition. It is not a medicinal product. Application does not exempt from visiting the dentist.

• mouthwash

Fluoride mouth rinses for the prevention of dental caries in children and adolescents

Review question

How effective and safe is fluoride mouthwash in preventing tooth decay (dental caries) in children and adolescents compared to placebo (a mouthwash without the active fluoride ingredient) or no treatment?

Relevance

Dental caries is a global health problem affecting the vast majority of adults and children. Rates of dental caries vary between and within countries, but children from lower socioeconomic groups (measured by income, education and employment) are more likely to have dental caries. Left untreated, cavities can lead to gradual decay of the tops of the teeth (crowns), often accompanied by intense pain. Restoring and replacing decayed teeth is time consuming and costly and is one of the major health care costs.

Prevention of caries in children and adolescents is a priority in dentistry, which is considered more cost-effective than treatment. Minerals – fluorides are widely used to prevent dental caries. In addition to being a naturally occurring fluoride, it is added to the water supply in some regions and used in most toothpastes and other products available to varying degrees throughout the world. As an additional preventive measure, fluorides can be applied directly to the teeth in the form of rinses, lozenges, varnishes, and gels.

Fluoride rinses were often used under specialist supervision as part of school dental caries prevention programs. Fluoride mouthwashes, with or without specialist supervision (depending on the child’s age), must be used regularly to be effective. The recommended procedure includes rinsing the mouth with a less concentrated solution containing fluoride for 1-2 minutes a day, or with a more concentrated solution once a week or every two weeks. Due to the risk of swallowing too much fluoride, fluoride rinses are not recommended for children under 6 years of age.

This review is an update of the Cochrane Review of Fluoride Mouthwashes for the Prevention of Dental Caries in Children and Adolescents, first published in 2003. We assessed existing research for the Cochrane Oral Health Group and evidence up to 22 April 2016.

Study profile

We included 37 studies in which more than 15,000 children (aged 6 to 14 years) were treated with fluoride mouthwash or placebo (a mouthwash without active ingredient) or no treatment. All studies evaluated supervised use of fluoride mouthrinses in school settings, and two studies also evaluated their use at home. Most children received sodium fluoride (NaF) at 230 parts per million fluoride (ppm F) daily or higher 900 ppm F once a week or every 2 weeks. The studies continued for 2 to 3 years. The reports were published between 1965 and 2005, and the studies themselves were carried out in several countries.

Main results

This review update confirms that regular, supervised use of a fluoride mouthrinse can reduce the incidence of dental caries in children and adolescents. Pooled results from 35 clinical trials showed that fluoride mouthrinse reduced decayed, lost, and filled surfaces in permanent teeth by an average of 27% compared with placebo or no rinse. Children are likely to benefit even if they use fluoride-containing toothpaste or live in a region with fluoridated water. Pooled results from 13 clinical trials showed that decayed, lost, and filled permanent teeth (rather than tooth surfaces) decreased by an average of 23% with fluoride mouthrinse compared to placebo or no rinse. None of the studies looked at the effect of fluoride rinses on milk teeth. We found little information about unwanted side effects and how well children did with mouthwashes.